Evaluation of a Few Biomarkers among COVID-19 Patients

  • Rusul Heider Mohsin Department of Anesthesia, Hilla University Collage, Babylon, Iraq.
  • Deemah Saeb Abdul Hussein Department of Anesthesia, Hilla University Collage, Babylon, Iraq.
  • Ahmed S Abed Department of Medical Physics, Hilla University Collage, Babylon, Iraq.
Keywords: COVID-19, Lactate Dehydrogenase (LDH), IL-6, D-dimer, C-reactive Protein, Ferritin

Abstract

Introduction: In the present study, the mean differences of Lactate Dehydrogenase (LDH), D-dimer, C-reactive protein, interleukin-6 and ferritin levels concentrations between study groups (patients with severe COVID-19 symptoms and patients with mild symptoms) compared tothe control group. The results showed that there were significant increased concentrations of biomarkers levels in group A as compared with group B and control.

Objective: This present study aims to evaluate the COVID-19 biomarkers(Lactate Dehydrogenase (LDH), D-dimer, C-reactive protein, IL-6 and ferritin concentrations) among COVID-19 patients.

Methodology: A total of 75 blood samples were collected from male patients with age groups ranging between 30 and 75 years who were suffering from coronavirus. Three groups were included in this study; each group includes 25 patients. Group A patients suffering from coronavirus with severe symptoms, group B patients suffering from coronavirus with mild symptoms and group C with healthy patients as control. All parameters were measured according to standard procedures. Data were analysed in SPSS version 20 by using mean ± SD.Significant association was established by chi-square test taking p-value<0.05.

Results: Increased LDH values were linked to an increase in COVID-19 toxicity. On the basis of D-dimer, the probability of mortality can be determined. C-responsive protein and ferritin serum exercises were significantly increased in COVID-19 patients compared to those with mild side effects of COVID-19. IL-6 is a key immunomodulatory cytokine in both normal and infected tissues.

Conclusion: LDH, D-dimer, C-reactive protein and serum ferritin are good predictors of COVID-19 severity and may be used for the assessment of clinical outcome.

How to cite this article:
Mohsin RH, Hussein DSA, Abed AS. Evaluation of a Few Biomarkers among COVID-19 Patients. Special Issue - COVID-19 & Other Communicable Disease. 2022;82-90.

DOI: https://doi.org/10.24321/0019.5138.202213

References

Pityana NB. A theological statement on the coronavirus pandemic: living the faith responsibly. Relig Theol. 2020;27(3-4):329-58. [Google Scholar]

Ambrose PM. High throughput genetics and characterization of an RNA Arbovirus, Sindbis virus, using accurate next-generation sequencing of viral evolution and RNA enrichment [dissertation]. Weill Medical College of Cornell University. ProQuest Dissertations Publishing; 2020. [Google Scholar]

Rangayasami A, Kannan K, Murugesan S, Radhika D, Sadasivuni KK, Reddy KR, Raghu AV. Influence of nanotechnology to combat against COVID-19 for global health emergency: a review. Sens Int. 2021;2:100079. [PubMed] [Google Scholar]

Ortiz-Prado E, Simbaña-Rivera K, Gómez-Barreno L, Rubio-Neira M, Guaman LP, Kyriakidis NC, Muslin C, Jaramillo AMG, Barba-Ostria C, Cevallos-Robalino D, Sanches-SanMiguel H, Unigarro L, Zalakeviciute R, Gadian N, López-Cortés A. Clinical, molecular and epidemiological characterization of the SARS-CoV2 virus and the Coronavirus disease 2019 (COVID-19), a comprehensive literature review. DiagnMicrobiol Infect Dis. 2020 Sep;98(1):115094. [PubMed] [Google Scholar]

Qasim QA, Hussein HH, Shari FH, Al-Salman HNK, Ahmed, GS, Jeber MA. General study: the effect of corpulence and persistent sicknesses on the seriousness of the diseases with COVID-19. Int J Pharm Res. 2020;12(3):3539-64.†[Google Scholar]

Ali SR, Dobbs TD, Whitaker IS. Webinars in plastic and reconstructive surgery training-a review of the current landscape during the COVID-19 pandemic. J PlastReconstrAesthet Surg. 2020 Jul;73(7):1357-404. [PubMed] [Google Scholar]

Bae S, Kim SR, Kim MN, Shim WJ, Park SM. Impact of cardiovascular disease and risk factors on fatal outcomes in patients with COVID-19 according to age: a systematic review and meta-analysis. Heart. 2021 Mar;107(5):373-80. [PubMed] [Google Scholar]

Guery B, Poissy J, el Mansouf L, Séjourné C, Ettahar N, Lemaire X, Vuotto F, Goffard A, Behillil S, Enouf V, Caro V, Mailles A, Che D, Manuguerra JC, Mathieu D, Fontanet A, van der Werf S; MERS-CoV study group. Clinical features and viral diagnosis of two cases of infection with Middle East Respiratory Syndrome coronavirus: a report of nosocomial transmission. Lancet. 2013 Jun;381(9885):2265-72. [PubMed] [Google Scholar]

Huang J, Mao T, Li S, Wu L, Xu X, Li H, Xu C, Su F, Dai J, Shi J, Cai J. Long period dynamics of viral load and antibodies for SARS-CoV-2 infection: an observational cohort study. MedRxiv. 2020 Jan 1. [Google Scholar]

Assadullah Z, Kumar A, Kumar P, Barik M. Guidelines and protocol development for Molecular Targeted Therapy (MMT) for COVID-19 patients.†[Google Scholar]

Zuo YY, Uspal WE, Wei T. Airborne transmission of COVID-19: aerosol dispersion, lung deposition, and virus-receptor interactions. ACS Nano. 2020 Nov;acsnano.0c08484. [PubMed] [Google Scholar]

Schwartz DA. An analysis of 38 pregnant women with COVID-19, their newborn infants, and maternal-fetal transmission of SARS-CoV-2: maternal coronavirus infections and pregnancy outcomes. Arch Pathol Lab Med. 2020 Jul;144(7):799-805. [PubMed] [Google Scholar]

Zhang W, Zhao Y, Zhang F, Wang Q, Li T, Liu Z, Wang J, Qin Y, Zhang X, Yan X, Zeng X, Zhang S. The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): the perspectives of clinical immunologists from China. ClinImmunol. 2020 May;214:108393. [PubMed] [Google Scholar]

Menter T, Haslbauer JD, Nienhold R, Savic S, Hopfer H, Deigendesch N, Frank S, Turek D, Willi N, Pargger H, Bassetti S, Leuppi JD, Cathomas G, Tolnay M, Mertz KD, Tzankov A. Postmortem examination of COVIDâ€19 patients reveals diffuse alveolar damage with severe capillary congestion and variegated findings in lungs and other organs suggesting vascular dysfunction. Histopathology. 2020 Aug;77(2):198-209. [PubMed] [Google Scholar]

Xu K, Cui K, Young LH, Wang YF, Hsieh YK, Wan S, Zhang J. Air quality index, indicatory air pollutants and impact of COVID-19 event on the air quality near central China. Aerosol Air Qual Res. 2020;20(6):1204-21.†[Google Scholar]

Bai HX, Wang R, Xiong Z, Hsieh B, Chang K, Halsey K, Tran TML, Choi JW, Wang DC, Shi LB, Mei J, Jiang XL, Pan I, Zeng QH, Hu PF, Li YH, Fu FX, Huang RY, Sebro R, Yu QZ, Atalay MK, Liao WH. Artificial intelligence augmentation of radiologist performance in distinguishing COVID-19 from pneumonia of other origin at chest CT. Radiology. 2020 Sep;296(3):E156-65. [PubMed] [Google Scholar]

Upadhyay M, Yadav S, Nagaraj K, Patil S. Treatment effects of mini-implants for en-masse retraction of anterior teeth in bialveolar dental protrusion patients: a randomized controlled trial. Am J OrthodDentofacialOrthop. 2008 Jul;134(1):18-29.e1. [PubMed] [Google Scholar]

Krishna Kumar B, Rana S. COVID 19 in INDIA: strategies to combat from combination threat of life and livelihood. J MicrobiolImmunol Infect. 2020 Jun;53(3):389-91. [PubMed] [Google Scholar]

Pfefferbaum B, North CS. Mental health and the COVID-19 pandemic. N Engl J Med. 2020;383:510-2. [Google Scholar]

Hsu LY, Chia PY, Lim JF. The Novel corona virus (SARS-CoV-2) epidemic. Ann Acad Med Singap. 2020 Mar;49(3):105-7. [PubMed] [Google Scholar]

Jones KE, Patel NG, Levy MA, Storeygard A, Balk D, Gittleman JL, Daszak P. Global Trends in emerging infectious diseases. Nature. 2008 Feb;451(7181):990-3. [PubMed] [Google Scholar]

Lupia T, Scabini S, Mornese Pinna S, Di Perri G, De Rosa FG, Corcione S. 2019 novel corona virus (2019-nCoV) outbreak: a new challenge. J Glob Antimicrob Resist. 2020 Jun;21:22-7. [PubMed] [Google Scholar]

Madhav N, Oppenheim B, Gallivan M, Mulembakani P, Rubin E, Wolfe N, Jamison DT, Gelband H, Horton S, Jha P, Laxminarayan R, Mock CN, Nugent R, editors. Pandemics: risks, impacts, and mitigation. In: Disease control priorities: improving health and reducing poverty. 3rd ed. Washington (DC): The International Bank for Reconstruction and Development,The World Bank; 2017. [PubMed] [Google Scholar]

Omer SB, Malani P, del Rio C. The COVID-19 pandemic in the US: a clinical update. JAMA. 2020 May;323(18):1767-8. [PubMed] [Google Scholar]

De P. COVID-19, new normal and India [Internet]. The Economic Times; 2020 [cited 2020 Apr 9]. Available from: https://economictimes.indiatimes.com/blogs/et-commentary/covid-19-new-normal-and-india/

Wang H, Wang S, Yu K. COVID-19 infection epidemic: the medical management strategies in Heilongjiang Province, China. Crit Care. 2020 Mar;24(1):107. [PubMed] [Google Scholar]

Yang Y, Bazhin AV, Werner J, Karakhanova S. Reactive oxygen species in the immune system. Int Rev Immunol. 2013 Jun;32(3):249-70. [PubMed] [Google Scholar]

Smith JA. Neutrophils, host defense, and inflammation: a doubleâ€edged sword. J Leukoc Biol. 1994 Dec;56(6):672-86. [PubMed] [Google Scholar]

Bryan N, Ahswin H, Smart N, Bayon Y, Wohlert S, Hunt JA. Reactive oxygen species (ROS) - a family of fate deciding molecules pivotal in constructive inflammation and wound healing. Eur Cell Mater. 2012 Sep;24:249-65. [PubMed] [Google Scholar]

Henry BM, Aggarwal G, Wong J, Benoit S, Vikse J, Plebani M, Lippi G. Lactate dehydrogenase levels predict coronavirus disease 2019 (COVID-19) severity and mortality: a pooled analysis. Am J Emerg Med. 2020 Sep;38(9):1722-6. [PubMed] [Google Scholar]

Malik P, Patel U, Mehta D, Patel N, Kelkar R, Akrmah M, Gabrilove JL, Sacks H. Biomarkers and outcomes of COVID-19 hospitalisations: systematic review and meta-analysis. BMJ Evid Based Med. 2021 Jun;26(3):107-8. [PubMed] [Google Scholar]

Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M, Psaltopoulou T, Gerotziafas G, Dimopoulos MA. Hematological findings and complications of COVIDâ€19. Am J Hematol. 2020 Jul;95(7):834-47. [PubMed] [Google Scholar]

Sun J, Su J, Xie Y, Yin MT, Huang Y, Xu L, Zhou Q, Zhu B. Plasma IL-6/IL-10 ratio and IL-8, LDH, and HBDH level predict the severity and the risk of death in AIDS patients with pneumocystis pneumonia. J Immunol Res. 2016;2016:1583951. [PubMed] [Google Scholar]

Wei XL, Zhang DS, He MM, Jin Y, Wang DS, Zhou YX, Bai L, Li ZZ, Luo HY, Wang FH, Xu RH. The predictive value of alkaline phosphatase and lactate dehydrogenase for overall survival in patients with esophageal squamous cell carcinoma. Tumour Biol. 2016 Feb;37(2):1879-87. [PubMed] [Google Scholar]

Mishra D, Banerjee D. Lactate dehydrogenases as metabolic links between tumor and stroma in the tumor microenvironment. Cancers (Basel). 2019 May;11(6):750. [PubMed] [Google Scholar]

Ding J, Karp JE, Emadi A. Elevated lactate dehydrogenase (LDH) can be a marker of immune suppression in cancer: interplay between hematologic and solid neoplastic clones and their microenvironments. Cancer Biomark. 2017 Jul;19(4):353-63. [PubMed] [Google Scholar]

Akagawa M, Minematsu K, Shibata T, Kondo T, Ishii T, Uchida K. Identification of lactate dehydrogenase as a mammalian pyrroloquinolinequinone (PQQ)-binding protein. Sci Rep. 2016 May;6:26723. [PubMed] [Google Scholar]

Baumgart E, Fahimi HD, Stich A, Völkl A. L-lactate dehydrogenase A4-and A3B isoforms are bona fide peroxisomal enzymes in rat liver: evidence for involvement in intraperoxisomal NADH reoxidation. J Biol Chem. 1996 Feb;271(7):3846-55. [PubMed] [Google Scholar]

Maldonado V, Hernandez-Ramírez C, Oliva-Pérez EA, Sánchez-Martínez CO, Pimentel-González JF, Molina-Sánchez JR, Jiménez-Villalba YZ, Chávez-Alderete J, Loza-Mejía MA. Pentoxifylline decreases serum LDH levels and increases lymphocyte count in COVID-19 patients: results from an external pilot study. IntImmunopharmacol. 2021 Jan;90:107209. [PubMed] [Google Scholar]

Han Y, Zhang H, Mu S, Wei W, Jin C, Tong C, Song Z, Zha Y, Xue Y, Gu G. Lactate dehydrogenase, an independent risk factor of severe COVID-19 patients: a retrospective and observational study.Aging (Albany NY). 2020 Jun;12(12):11245-58. [PubMed] [Google Scholar]

Klein R, Nagy O, Tóthová C, Chovanová F. Clinical and diagnostic significance of lactate dehydrogenase and its isoenzymes in animals. Vet Med Int. 2020 Jun;2020:5346483. [PubMed] [Google Scholar]

Fu J, Kong J, Wang W, Wu M, Yao L, Wang Z, Jin J, Wu D, Yu X. The clinical implication of dynamic neutrophil to lymphocyte ratio and D-dimer in COVID-19: a retrospective study in Suzhou China. Thromb Res. 2020 Aug;192:3-8. [PubMed] [Google Scholar]

Ye W, Chen G, Li X, Lan X, Ji C, Hou M, Zhang D, Zeng G, Wang Y, Xu C, Lu W, Cui R, Cai Y, Huang H, Yang L. Dynamic changes of D-dimer and neutrophil-lymphocyte count ratio as prognostic biomarkers in COVID-19. Respir Res. 2020 Jul;21(1):169. [PubMed] [Google Scholar]

He X, Yao F, Chen J, Wang Y, Fang X, Lin X, Long H, Wang Q, Wu Q. The poor prognosis and influencing factors of high D-dimer levels for COVID-19 patients. Sci Rep. 2021 Jan;11(1):1830. [PubMed] [Google Scholar]

Bao J, Li C, Zhang K, Kang H, Chen W, Gu B. Comparative analysis of laboratory indexes of severe and non-severe patients infected with COVID-19. ClinChimActa. 2020 Oct;509:180-94. [PubMed] [Google Scholar]

Cerdà P, Ribas J, Iriarte A, Mora-Luján JM, Torres R, Del Río B, Jofre HI, Ruiz Y, Huguet M, Fuset MP, Martínez-Yélamos S, Santos S, Llecha N, Corbella X, Riera-Mestre A. Blood test dynamics in hospitalized COVID-19 patients: potential utility of D-dimer for pulmonary embolism diagnosis. PLoS One. 2020 Dec;15(12):e0243533. [PubMed] [Google Scholar]

Soy M, Keser G, Atagündüz P, Tabak F, Atagündüz I, Kayhan S. Cytokine storm in COVID-19: pathogenesis and overview of anti-inflammatory agents used in treatment. ClinRheumatol. 2020 Jul;39(7):2085-94. [PubMed] [Google Scholar]

Tan M, Liu Y, Zhou R, Deng X, Li F, Liang K, Shi Y. Immunopathological characteristics of coronavirus disease 2019 cases in Guangzhou, China. Immunology. 2020 Jul;160(3):261-8. [PubMed] [Google Scholar]

Herrmann J, Mori V, Bates JHT, Suki B. Modeling lung perfusion abnormalities to explain early COVID-19 hypoxemia. Nat Commun. 2020 Sep;11(1):4883. [PubMed] [Google Scholar]

Moriarty PM, Gorby LK, Stroes ES, Kastelein JP, Davidson M, Tsimikas S. Lipoprotein (a) and its potential association with thrombosis and inflammation in COVID-19: a testable hypothesis. CurrAtheroscler Rep. 2020 Jul;22(9):48. [PubMed] [Google Scholar]

Du Clos TW. Function of C-reactive protein. Ann Med. 2000 May;32(4):274-8. [PubMed] [Google Scholar]

Channappanavar R, Perlman S. Age-related susceptibility to Coronavirus infections: role of impaired and dysregulated host immunity. J Clin Invest. 2020 Dec;130(12):6204-13. [PubMed] [Google Scholar]

Szabo PA, Dogra P, Gray JI, Wells SB, Connors TJ, Weisberg SP, Krupska I, Matsumoto R, Poon MML, Idzikowski E, Morris SE, Pasin C, Yates AJ, Ku A, Chait M, Davis-Porada J, Guo XV, Zhou J, Steinle M, Mackay S, Saqi A, Baldwin MR, Sims PA, Farber DL. Longitudinal profiling of respiratory and systemic immune responses reveals myeloid cell-driven lung inflammation in severe COVID-19. Immunity. 2021 Apr;54(4):797-814.e6. [PubMed] [Google Scholar]

Coperchini F, Chiovato L, Ricci G, Croce L, Magri F, Rotondi M. The Cytokine storm in COVID-19: further advances in our understanding the role of specific chemokines involved. Cytokine Growth Factor Rev. 2021 Apr;58:82-91. [PubMed] [Google Scholar]

Rendeiro AF, Casano J, Vorkas CK, Singh H, Morales A, DeSimone RA, Ellsworth GB, Soave R, Kapadia SN, Saito K, Brown CD, Hsu J, Kyriakides C, Chiu S, Cappelli LV, Cacciapuoti MT, Tam W, Galluzzi L, Simonson PD, Elemento O, Salvatore M, Inghirami G. Profiling of immune dysfunction in COVID-19 patients allows early prediction of disease progression. Life Sci Alliance. 2020 Dec;4(2):e202000955. [PubMed] [Google Scholar]

Fraga-Silva TFC, Maruyama SR, Sorgi CA, Russo EMS, Fernandes APM, de Barros Cardoso CR, Faccioli LH, Dias-Baruffi M, Bonato VLD. COVID-19: integrating the complexity of systemic and pulmonary immunopathology to identify biomarkers for different outcomes. Front Immunol. 2021 Jan;11:599736. [PubMed] [Google Scholar]

Taefehshokr N, Taefehshokr S, Heit B. Mechanisms of dysregulatedhumoral and cellular immunity by SARS-CoV-2. Pathogens. 2020 Dec;9(12):1027. [PubMed] [Google Scholar]

Castiglione F, Deb D, Srivastava AP, Liò P, Liso A. From infection to immunity: understanding the response to SARS-CoV2 through in-silicomodeling. Front Immunol. 2021 Sep;12:646972. [PubMed] [Google Scholar]

To KK, Sridhar S, Chiu KH, Hung DL, Li X, Hung IF, Tam AR, Chung TW, Chan JF, Zhang AJ, Cheng VC, Yuen KY. Lessons learned one year after SARS-CoV-2 emergence leading to COVID-19 pandemic. Emerg Microbes Infect. 2021 Dec;10(1):507-35. [PubMed] [Google Scholar]

Brunet-Ratnasingham E, Anand SP, Gantner P, Dyachenko A, Moquin-Beaudry G, Brassard N, Beaudoin-Bussières G, Pagliuzza A, Gasser R, Benlarbi M, Point F, Prévost J, Laumaea A, Niessl J, Nayrac M, Sannier G, Orban C, Messier-Peet M, Butler-Laporte G, Morrison DR, Zhou S, Nakanishi T, Boutin M, Descôteaux-Dinelle J, Gendron-Lepage G, Goyette G, Bourassa C, Medjahed H, Laurent L, Rébillard RM, Richard J, Dubé M, Fromentin R, Arbour N, Prat A, Larochelle C, Durand M, Richards JB, Chassé M, Tétreault M, Chomont N, Finzi A, Kaufmann DE. Integrated immunovirological profiling validates plasma SARS-CoV-2 RNA as an early predictor of COVID-19 mortality. Sci Adv. 2021 Nov;7(48):eabj5629. [PubMed] [Google Scholar]

Heinz C, Miesbach W, Herrmann E, Sonntagbauer M, Raimann FJ, Zacharowski K, Weber CF, Adam EH. Greater fibrinolysis resistance but no greater platelet aggregation in critically ill COVID-19 patientsAnesthesiology. 2021 Mar;134(3):457-67. [PubMed] [Google Scholar]

Published
2022-03-16